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. 2007 Aug;28(3):79–92.

Table 4.

Recommended protocol for laboratory investigation of PCOS.

First line tests
To confirm hyperandrogenaemia and exclude significant hyperprolactinaemia, thyroid disease or premature ovarian failure
Testosterone, SHBG, prolactin, thyroid function tests, FSH

Follow up tests (in order)
Only instigate if testosterone is >4 nmol/L (after solvent extraction if methodology suspect – see text)
 1) To investigate extent of hyperandrogenaemia and provide supportive evidence for late onset congenital adrenal hyperplasia (CAH) or Cushing’s syndrome.
Androstenedione, DHEAS, 17-OHP, urinary free cortisol.
 2) To diagnose CAH
Only instigate if 17-OHP is >6 nmol/L
Serum 17-OHP before and 60 mins after Synacthen (250 ug i.v.)
Urinary steroid profile
 3) To diagnose androgen secreting tumour
These tumours are not common; only perform test if no other explanation for significantly elevated testosterone
Serum testosterone before and after 48h low dose (2 mg/day) dexamethasone
Urinary steroid profile